Provider profiling: severity-adjusted versus severity-based outcomes
| Autor: | Stephen W. Imler |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
Education Continuing Provider profiling macromolecular substances Medicare Severity of Illness Index Centers for Medicare and Medicaid Services U.S Case mix index Documentation Severity of illness Outcome Assessment Health Care Medicine Profiling (information science) Humans Statistic Diagnosis-Related Groups business.industry Health Policy Public Health Environmental and Occupational Health Benchmarking Length of Stay Hospitals United States Emergency medicine Acute Disease Analysis of variance business Surgery Department Hospital Software |
| Zdroj: | Journal for healthcare quality : official publication of the National Association for Healthcare Quality. 19(6) |
| ISSN: | 1062-2551 |
| Popis: | Providers will continue to experience increasing pressure to demonstrate cost-effective, high-quality care. For relevant comparisons between providers, outcomes must be evaluated with respect to severity of illness and mortality risk. However, most hospitals use patient classification methods, such as Medicare and Health Care Financing Administration diagnosis-related groups (DRGs), which group together different levels of severity and mortality risk. The most common approach for developing severity-adjusted outcomes for groups of cases with dissimilar severity levels is to divide a statistic by a factor such as the Medicare case mix index, which was not designed or intended for that purpose. As an alternative, providers are increasingly using severity-based methods that classify patients as to severity levels within each diagnosis-related group. The key to severity-based profiling is the classification of cases to similar patient groups and comparison to selected benchmarks for variance analysis at each severity level. Effective provider profiling requires that hospital staff and physicians work together toward the common goal of accurate and complete documentation and coding of all medical conditions. Through use of more accurate severity-based profiling, providers are better able to identify opportunities to improve performance and demonstrate cost-effectiveness and quality to buyers, beneficiaries, and third-party reviewers. |
| Databáze: | OpenAIRE |
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